Doctors, not porn, are driving the rise of genital cosmetic surgeries

Jessica Pin
4 min readJun 8, 2018

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The media consistently scapegoats pornography as the main culprit behind the rise in female genital cosmetic surgeries. Unless we are only talking about Playboy and other softcore porn, this is total bullshit.

There are a great many popular porn stars who have labia minora resembling those in the “before” photos on physician websites and in medical journals. Do I need to name names? Meanwhile, medical defintions of hypertrophy begin at 2 cm, which is less than the mean found in normative studies.

A wide range of vulvar morphology is represented in hardcore pornography. In fact, it may arguably be the most representative source of realistic vulvar anatomy, especially when amateur porn is considered. Also, do people really think those Eastern Eurpean teenagers getting into porn can afford cosmetic surgery? No. They can’t. Do people really think porn producers are telling otherwise attractive women with large labia minora, who want to fuck on camera, to fuck off? No. That isn’t happening except maybe in super extreme cases. The assumptions people seem to be making here are truly bizarre. Have they ever seen porn?

Qualitatively, it appears that the distribution of morphology exhibited in explicit pornography is not much different than that exhibited in pre-operative photos in published medical journals and surgeons’ websites. Even the AVN winner of 2010 and 2011 female performer of the year has “enlarged” labia according to the standards purported by many labiaplasty surgeons. However, it is notable that whether or not her labia are shown as protruding varies with the explicitness of visual media. In addition, it is interesting to note the abundance of positive comments regarding performers’ so called hypertrophic labia on pornographic websites. Disparaging comments regarding large labia are nearly impossible to find, even if a focused effort is made.

Though Playboy has no doubt affected the public’s perception of an ideal vulvar aesthetic to some degree, an ideal of invisible labia minora is not supported by the content of more explicit media. Additionally, studies indicate that the alleged influence of pornography on the rise of genital surgery is exaggerated. Rather, patients primarily report being influenced by medical representations of normality and aesthetic ideals than by pornography.

In one study of women seeking surgery under the NHS, “eleven (33%) of the participants reported having seen advertisements for FGCS, five (15%) reported having looked up medical illustrations and four (12%) reported having viewed pornography. Thus, in this sample, pornography accounted for 20% of reported sources of information regarding vulvar aesthetic ideas. Meanwhile, 80% of reported sources were medical sources.

In another study of interest in cosmetic gential surgery and perceptions of normal vulvar appearance, sources of information about normal vulvar appearance were assessed. Of 207 women aged 18–44, 6.44% responded that they used pornography as a source of information about vulvar appearance. Meanwhile, of 147 women aged 45–72, only 0.75% of women responded that they used pornography. Thus, while it is clear that younger women more often use pornography as a source of information than older women do, the relative contribution of pornography to perceptions of normality is insignificant across both age groups. By contrast, it is clear that a great many women rely on medical sources for information on normal vulvar appearance .

It is important to acknowledge that while the Internet has led to increased access pornography, it has also lead to increased access to and availability of medical information, including anatomy textbooks, journal articles, and patient education resources. It has also led to increased exposure to advertisements of medical procedures.

False beliefs about protruding labia minora in medical literature

There is a long history of stigmatization of large labia in the medical literature. Stigma primarily originates from false beliefs about labia minora development. Some false beliefs are still widely held in the current medical community. Others, though generally abandoned, are still occasionally published in medical literature and continue to persist in popular perceptions. The most pernicious false beliefs are listed below:

False beliefs about large labia in the medical literature influence patient misconceptions of abnormality and defect both directly and indirectly. Direct influence occurs when patients access medical research in order to determine normality of labia size, and potential “need” for correction. In addition, stigmatization in the medical literature influences patient misconceptions indirectly though it’s influence on physicians’ practicing knowledge. Likewise, public perceptions influence individual doctors, leading to continued appearance of false beliefs in the medical literature. The increased prevalence of labiaplasty procedures appears to have triggered a marked resurgence of false beliefs in the literature. Some, such as the misguided association of large labia with androgens, appear to have been invented for the express purpose of justifying labiaplasty. Others, such as the false belief that excess masturbation causes large labia, have experienced a resurgence due to their utility in providing incentive for labiaplasty. These false beliefs are conveniently used to frame large labia as negative in order to justify labiaplasty as treatment.

I have 5 pages of explanation and examples of this particular problem, with nearly 40 references cited. This would be a lot of work to add to Medium. Maybe what I need to do is update, edit, and finish my entire paper, but I don’t know what content matters.

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Jessica Pin

Getting clitoral neural anatomy included in OB/GYN textbooks. It was finally added for the first time in July 2019. BME/EE @WUSTL